Defogging device helps surgeons see better

The surgical tech at Broward General Medical Center noticed a peculiar technique surgeons regularly employed to keep their equipment from fogging up during surgery: dunking it in a bucket of warm water at the foot of the operating table.

The archaic ritual, commonly conducted in otherwise sophisticated operating rooms across the country, so struck Alexander Gomez that he eventually designed a simple yet effective solution.

Seven years later, the D-HELP defogging device, designed in Gomez's Cornell Medical College dorm room, is now in use in laparoscopic and robotic surgeries at more than 800 U.S. hospitals, including most of South Florida's.

The invention has grown so popular, its sales have launched Gomez's Coral Springs company, New Wave Surgical Corp., onto Inc. 500's 2012 list of the fastest growing companies in the United States.

"It's changed laparoscopic surgery significantly," said Dr. Avraham Belizon, a Delray Beach colorectal and general surgeon who specializes in laparoscopic and robotic surgeries. "It's a simple concept he's come up with. I give him lots of credit."

The problem solved by the D-HELP (short for Defogging Heated Endoscopic Lens Protector) had been confounding doctors and inventors alike for years, Belizon said.

In laparoscopic surgeries, a flexible fiber-optic instrument with a camera at the end is inserted through a small incision, allowing for minimally invasive procedures that have revolutionized medicine.

And yet, these high-tech scopes had a common problem: Chilled from spending time on the instrument table in the operating room's 50-degree air, they'd fog up moments after being placed into a patient's warm body, requiring surgeons to pull them out frequently, dunk them in warm water and wipe off the camera lens with gauze.

"It's crazy," Gomez said of the years he spent assisting on such operations as a certified surgical technician. "Here you have the most advanced procedures going on in front of you, and you're sitting there filling buckets with hot water. I thought, this makes no sense."

It not only made little sense, "it was annoying," Belizon said of constantly having to stop the procedure to dunk the expensive camera in water, wipe it off and start again, costing the patient more time under anesthesia.

At first, Gomez thought the water-dunking technique was particular to South Florida hospitals like Broward General, now called Broward Health Medical Center. But when he went to Cornell for medical school and saw the same technique there while moonlighting as a surgical tech, he realized how pervasive the problem was and that no one had yet come up with an effective solution.

Tapping his familiarity with the operating room and a childhood spent watching his engineer father tinker with his own creations, Gomez designed a small, battery-operated device that fits over the end of the laparoscope, submerging the camera tip in a heated cleansing fluid until the doctor is ready to use it.

At the start of surgery, the scope is pulled out of the D-HELP, wiped off with a sterile microfiber cloth and used — with little to none of the fogging from before. The $40 device is completely sterile and designed to be used for one procedure, then thrown away, Gomez said.

And with the rise in popularity of robotic procedures, doctors are finding the D-HELP to be, well, helpful in cutting down on the fogging of that equipment, too.

"It's an effective solution, there's no doubt about it," Belizon said, adding that other products had attempted to mitigate the fogging but none really worked. "This is the one that really took the prize."

After a couple of years of toying with the D-HELP concept, Gomez decided to forgo a career in medicine and dedicate his energies to his invention. In 2006, he incorporated New Wave Surgical Corp. in Queens, N.Y., then moved the operation and its eight employees to larger and less expensive quarters in Coral Springs three years later.

Now topping out at nearly 100 employees, and with about 35,000 D-HELP devices in use in U.S. hospitals each month, Gomez is moving the company in March to even bigger digs — a 32,000-square-foot facility in Pompano Beach.

About 90 percent of the hospitals in South Florida — including the entire Broward Health system, his one-time employer — use it.

"It's very popular, and it's very well-used," said Deleta Dacosta, nurse educator in the Broward Health Medical Center operating room, where Gomez once filled buckets with warm water. "It has been very effective."

And while doctors like Belizon are no longer frustrated by the repetitive moisture buildup during an intricate procedure, it's the patient who is best served by Gomez's invention.

"When doctors can see what they're doing, it's better for the patient. When doctors can focus their energy on the surgery instead of cleaning the camera, it's better for the patient," Belizon said. "So all in all, the patient is the one who benefits the most."